Letters, June 2012

We can't work for free

As a psychology student nearing graduation, I have spent more than a little time of late perusing the jobs pages of The Psychologist and www.psychapp.co.uk. I have been very disappointed to note a number of advertisements for unpaid 'honorary' or voluntary assistant psychologist positions (e.g. April issue, p.323).

It is hardly a surprise that NHS trusts are increasingly offering these positions, as there is little doubt that there will be a lot of interest in them when competition to gain coveted assistant psychologist experience is so high. However, I strongly believe that these positions are bad for the development of psychology, and that the BPS, in representing many hundreds of psychology graduates, should oppose them on principle.

It's no secret that clinical psychology has a problem with diversity. Massive strides have been made in the last decade or so in increasing the representation of ethnic minorities, and attempts have started to be made to increase representation of other minority groups, such as people with disabilities or from lower socio-economic backgrounds. However, no matter how much is done to increase the diversity of the applicant pool to clinical psychology courses, attempts will fall far short of success if they fail to realise that part of the problem is that in order to get to a position where individuals can be successful in an application for a doctorate course, they must first gain the required experience. Undoubtedly, the proliferation of unpaid assistant psychology positions will make it much more difficult for applicants from disadvantaged backgrounds to compete with their more fortunate peers, who are more likely to be able to take on a voluntary position in order to gain experience.

The National Union of Students has launched a campaign against unpaid graduate internships, arguing that they create an unfair environment for those who cannot afford to take on unpaid work, for whatever reason. It's hard to argue that honorary assistant psychologist positions are anything other than psychology's version of an unpaid graduate internship. As the NUS campaign states, we can't work for free. Is it the right thing for the future of UK psychology to implicitly condone these positions by allowing them to advertise in The Psychologist? I am keen to prompt a debate in these pages
on the topic, so please do write to The Psychologist with your views.

Megan Down
Royal Holloway, University of London 

Raising awareness of specific language impairment

Everyone has heard of dyslexia and autism, but how many people are aware of specific language impairment (SLI)? SLI is similar to dyslexia in many ways: it's diagnosed when there is an unexplained impairment in development affecting a specific domain of functioning, but instead of written language, it's spoken language that creates difficulties.

In actual fact, problems with spoken language go hand in hand with problems of reading, but it's typically the reading difficulties that get most attention. We think this is wrong-headed; difficulties in talking or in understanding language are common: epidemiological studies suggest at least one child in every classroom is affected.

The impact on the child and the family can be serious: the language impairment often affects social interaction as well as educational attainment, and ultimately it limits the ability to participate in society and hold down a job. Yet because SLI is a hidden disability it often goes unnoticed and children's needs are neglected.

In 2011, we joined forced with fellow academics Courtenay Norbury and Gina Conti-Ramsden and with speech and language therapist Becky Clark to form a group called RALLI – Raising Awareness of Language Learning Impairments. This has been launched with funding support from Afasic, Afasic Cymru, The Waterloo Foundation and the Economic and Social Research Council.

Our goal is simple: we want awareness of SLI to be as widespread as awareness of dyslexia and autism. We've set up a YouTube channel that went live in May (see www.youtube.com/user/RALLIcampaign) and plan to post short videos there that will give information about SLI. We plan a mixture of content, ranging from interviews with children affected by SLI through to brief summaries of recent research.
Please do look at our site and tell other people about it.

Dorothy Bishop
Department of Experimental Psychology
University of Oxford
Maggie Snowling
Department of Psychology
University of York

Where have all the tables gone?

Tables and graphs have been used for years to enhance the presentation of scientific information. And, in addition to their obvious differences, some aspects of these features of text design are surprising. Did you know, for example, that there are more graphs and fewer tables in more prestigious psychology journals, and that this is reversed in less prestigious ones (see Smith et al., 2002)? And did you know graphs and tables presenting data illustrating differences between the sexes typically start off with the male data on the left? (see Hegarty et al., 2010)?

For some time now I have been pondering over the lack of tables and figures in the scientific articles in The Psychologist. We spend hours teaching our students how to use these tools, but then they never appear in our house magazine. At first I thought that the editor must be prejudiced against them. But the rules for presenting such materials in this journal are complex: the editor, Dr Jon Sutton, tells me: 'We have a policy of not accepting articles largely based on unpublished data – i.e. we are attempting to be a magazine, offering engaging and informative overviews of published research and developments in practice, rather than to be a "first port of call" journal. So if the table and the presentation of data within it was deemed to be a major part of a submitted article, it may fall foul of that policy.' (Personal communication, 21 February 2012)

Then I wondered how this situation compared with that in the American Psychological Association's Monitor and the Association for Psychological Science's Observer. Would they have more tables and graphs than The Psychologist? And just for good measure, what might be the situation in PsyPAG Quarterly, the British Psychological Society's publication for postgraduates, where the editor and most of the contributors are postgraduate students?

In order to check my suspicions that there were few if any tables and graphs in these 'magazines' I counted their numbers in a series of issues in each of them.

I totalled these, divided the totals by the number of issues examined, and adjusted the results for page size and the number of pages per issue.

In doing this I found it helpful to distinguish between numerical and verbal tables (e.g. those summarising the views of different researchers, and those presenting data). I also had to distinguish between line graphs, barcharts, flowcharts and figures. I counted figures if they were labelled Fig. 1, Fig. 2, etc. and were referred to by number in the text. I did not count any pictures or photographs – however apposite they might be – if they were simply added (possibly by picture editors) to enhance the attractiveness of the page without captions or figure numbers.

Table 1 shows the results. The results are clear. Even if they were adjusted for page size, number of issues, and number of pages devoted to articles, the results would be little different. Clearly, reading down the columns there is little difference between the three house-magazine journals, but PsyPAG Quarterly had many more of these features than did the house publications.

Why should this be so? Perhaps the reason lies in the editors' views that their publications are attempting to be magazines, offering engaging and informative overviews of published research rather than new data. PsyPAG Quarterly, of course, does the reverse,
and is not attempting to be a magazine.

But why are tables and figures not needed in magazines for psychologists? It would be interesting to see how house publications in different disciplines compare. Currently, though, these data suggest that in the eyes of our societies psychology is seen as an arts or social science discipline rather than a science.

And finally, I should perhaps note that my opening sentence about the relationship between graphs, tables and prestige in psychology journals has not stood the test of time. Hegarty and Walton (2012) report that psychology articles are more frequently cited these days if they contain fewer graphs and more structural equation models!
James Hartley
Keele University

References
Hegarty, P., Lemieux, A. & McQueen, G. (2010). Graphing the order of the sexes: Constructing, recalling, interpreting, and putting the self in gender different graphs. Journal of Personality and Social Psychology, 98(3), 375–391.
Hegarty, P. & Walton, Z. (2012). The consequences of predicting scientific impact in psychology using journal impact factors. Perspectives on Psychological Science, 7(1), 72–78.
Smith, L.D., Best, L.A., Stubbs, D.A. et al. (2002). Constructing knowledge: The role of graphs and tables in hard and soft psychology. American Psychologist, 57(10), 749–761.

The Editor, Dr Jon Sutton, replies:
I welcome a table, graph or figure when it adds something beyond conveying the information in words. (I would be interested in readers' views on whether your own table does that). But The Psychologist is not, and never claims to be, a journal. This means the presentation of data is rare, and it also means that there is considerable pressure on space within articles due to the costs of producing 50,000 copies each month. In this way we are similar to the APA Monitor and APS Observer, and your data supports that.

Echoes of a barbaric past?

I write not as a psychologist, but in relation to my expertise as a 'service user'. The subject matter is not intrinsically psychology focused, however it is a subject that I feel is relevant to all in mental health services, and is without doubt connected to psychology as a study.

My 'Road to Damascus' flash and inspiration to write this began when I received a letter one morning from a psychiatrist. It is amazing how one 'Did not attend' letter sparked such contemplation for me. Contemplation of a hope for a more personal approach to communication, and a seeking to unearth a more therapeutic-relationship-based approach in health altogether.

The letter simply read: '...We're sorry we didn't see you the other day, as we had hoped to review you in clinic...' Quite straightforward, you might think, but something instantly came to mind for me.

When I read this line, something didn't quite resonate right. To be 'reviewed', and in 'clinic', you could argue made me sound like a frog in a laboratory experiment. Now fortunately, I am of enough 'strength of mind' to take the letter at face value, realising no real thought is put in on the writer's side, it is just something that gets done (and most often by those at administrative level who have no reason to consider  the potential unintended impact of language). However, as a person who understands the various states of psychosis, the sensitivity of 'strength of mind' of a service user, especially on a bad day, I believe this kind of sentence could easily send someone spiralling further and further into psychotic and paranoid terror. I am sure you can appreciate that there is a harrowing reality to my point that I have to make here, one that I have lived through more than once. But I was of totally sound mind and the letter still bothered me.

What initially stood out for me was that within the chosen words used there was a strong implication that I was being dehumanised, specimenised, and also that I was very much of a mere numerical value to the service. Whether we like it or not, the rhetoric we employ makes this most often the case and is sadly a reflection of a deeper truth.
In light of this I felt that it could easily be for a different choice of words to be adopted, moving away from the cold and inanimate, to a more human, caring, relationship-based form of expression. This small act in itself may have some much greater significance within practice and across services.

I believe that language is very much part of the 'building-block' in how we create our worlds, be they worlds of research or practice or physical landscape of services and communities. Also in relation to this it is apparent that in the public there is a damaging level of mistrust for the medical profession. If we consider that it was only yesterday that patients were being labotomised for their mental health presentations, then it isn't too much of a leap of the imagination to realise that the rhetoric and language we continue to use today is full of the echoes of a rather barbaric past that can surely only perpetuate the mistrust (even if times have changed).

So can we dust away some of these cobwebs, take ownership of a communication with considered purpose and try and move everyone forward to somewhere more civilised? Indeed this could be a key way to effect the changes we would like. But the letter that sparked these thoughts is just one 'drop in the ocean'. Hence what I ultimately must advocate is more research in this area, done in a way that supports sustained better practice.

Perry Jackson
Community-Art Practitioner
and Service User Advocate
Spondon
Derby

Do it again!

Thank you for your efforts to keep improving our ever educative and informative magazine The Psychologist. The May edition was the best this year, due to the inclusion of 'Opinion' on the replication of experiments. I learnt a lot from it and I appreciate the fact that the opinion was taken from different professionals and not just psychologists.

It was interesting and informative: keep it coming. I agree it is important to replicate research before it is published. Unlike other scientists who deal with elements, psychologist should not be in a hurry to have their work published – we deal with human beings who look up to us for the most reliable results and answers to questions. I concur with Daniel J. Simons that 'if researchers know replication attempts will follow, they will be more cautious about publishing dubious data'.

Replication, whether strict or conceptual, is very necessary in psychological research. I think for the researcher, strict replication should be used and when the research is being carried out in a different location and/or with different population, especially research not involving laboratory experiment, conceptual replication should be used.

It is important to note that replication coming out positive or negative does not mean that the initial research was biased or falsified, but may mean that some factors were involved or excluded in either of the research. Based on this, researchers should not feel offended when the replication of their research fails, rather they should investigate the factors that led to the failure, which we can all learn from.

I also appreciate the innovation of PsychFileDrawer.org –
I think this site will make psychologists more scientific in carrying out research. Kudos to the inventors.
Adauzo Ijeoma Ubah
Clapham
London

It is a problem that failure to replicate is not published.
When I was a young tutor, my professor was so excited by the statistically significant results of a class experiment that he rushed into print. Next year, the same experiment did not replicate, although this was not published.

Later, when I was experimenting with readers' immediate response to spelling changes, I used samples from three populations with a control group and two pieces of text, and a colleague did the statistics for me. It seemed safe, and it was published. But a further experiment that tried to take it further had no significant findings, and it was rejected for publication. Attempted replication in Australia of the original experiment also had no significant findings, although results were in the same direction. So valuable information about experiments were never published because findings were null.

I was told that an Australian attempt to replicate Milgram failed – it was never published.
Valerie Yule
Mount Waverley
Victoria, Australia

Lessons from advanced physics...

Peter Johnson ('Theoretical work psychology', Letters, April 2012) suggests psychology can learn from Michael Frayn's great play Copenhagen, and I agree; the cross-fertilisation of theory and empirical study in advanced physics provides ample material for self-examination in the work of psychologists.But I think Frayn's play has rightly been called the most significant play of the 20th century (and I first saw it in London at the end of that century) because of some profound implications which should not be overlooked.

Frayn takes us through a series of reviews of the events towards the end of the Second World War, when Heisenberg visited Bohr in Copenhagen. The conclusion from these reviews is not that it is hard to know what really happened because of lack of sound evidence. The conclusion is that the concept that Heisenberg had a 'singular' view is meaningless. There is no singularity in anyone's 'view', such singularities are inherently meaningless. Frayn uses the very essence of the Copenhagen Interpretation – that there is no ultimate single meaning to the 'position and the speed' vectors of the electron – as an analogy for the very heart of psychology. There is no true meaning to the idea that I, or you, or anyone else, has a true view, or even a singular experience, we are all expressing Schrödinger waves of uncertainty, we are each and every one of those waves, our experiences are essentially an uncertainty of multiplicities of experience.

The implications for psychology are profound. Somehow we should be abandoning the idea that 'a person' is like this, or even 'did that'. We need a language that represents the neural uncertainty of all our experiences. We cannot be reductionist and 'accurate'.

I don't know quite how we do this, or how the public would feel if we entered a more appropriate era of telling it like it is, but it needs to be done or we continue with psychology as if, in physics, we were the Uncertainty Deniers, a possible theoretical position but one which requires review under strict theoretical and empirical processes.
Graham Rawlinson
Chichester

.. and one from literature

In 'Forum: The real world' by Steve Reicher and Alexander Haslam ('Letters', p.332, May 2012) it is suggested that 'panic' petrol buying has a basis in rationality. Joseph Heller in Catch-22 put the same thought succinctly into Yossarian's mouth. At the end of chapter 9, Major Major is trying to persuade Yossarian to fly even more missions, and he sensibly refuses. '"But suppose everybody on our side felt that way." "Then I'd certainly be a damned fool to feel any other way. Wouldn't I?"'
Pasco Ray
Strathdon
Aberdeenshire

Correction
In the note at the end of 'The journal of a mental hospital user in the 1960s' by Richard Hallam and myself ('Looking back', May 2012), it was stated that I was writing a book on people with dementia. I would be grateful if you could correct this statement, as I am writing a book for people with dementia. There is, of course, a large literature on dementia, and a sizeable literature for carers and relatives. What has been missing up to now is a book that specifically addresses the concerns and needs of people who fear they will be, or have been, assessed as having 'dementia'.
Mike Bender
Devon

FORUM - Beyond boundaries
Suicide is often considered a silencing, but for many it is only the beginning of the conversation. A common approach to understand those who have ended their own lives is the 'psychological autopsy' – a method that seeks to reconstruct the mental state of the deceased individual shortly before the final act. The testimony of friends and family is filtered through standardised assessments and psychiatric diagnoses. The narrative is 'stripped down' to the essential facts. A life is reduced to risk factors.
Psychologists Christabel Owens and Helen Lambert were struck by the contrast between the goal of the professionals in the interviews and how the friends and family of the deceased used the opportunity to tell their story and to make sense of their loss. 'The flow of narrative', they note in their recent study, 'can often be unstoppable'. The researchers returned to the transcripts of a 2003 psychological autopsy study, but instead of using the interview to construct variables, they looked at how the friends and families portrayed their lost companion.
As suicide is both stigmatised and stigmatising the personal accounts often contained portrayals of events that presupposed possible moral conclusions about the deceased. For example, by tradition, those who have cancer are discussed as heroic fighters, facing down death with courage and resolution. The default stories about people who commit suicide are not nearly so generous, however, and to navigate this treacherous moral territory bereaved friends and family often called on other, more acceptable, social stereotypes to make sense of the situation.
The suicides of women were largely portrayed in medical terms, as being so weakened by negative experiences that they were unable to prevent a decline into mental illness. The suicides of men, on the other hand, was barely ever described in terms of mental disorder. Male suicide was typically described either as the end result of having 'gone of the rails', a self-directed descent into antisocial behaviour, or as a 'heroic' action, demonstrating a final defiant act against an unjust world. Deaths were filtered through gender stereotypes of agency and accountability, perhaps to make them more acceptable to an unkind world. Owens and Lambert's study highlights the stark contrast between how researchers and family members interpret the same tragic events. As professionals, we often do surprisingly little to mesh together the bounded worlds of science and subjectivity, but the study demonstrates the power of the personal narrative. It affects us even after death.

- Vaughan Bell is a clinical psychologist and academic. Share your views on this and similar cross-cultural, interdisciplinary or 'boundary related' issues – e-mail [email protected].

Learning about asylums from inmates

Professor Hallam and Dr Mike Bender have done us a service in publishing David's Box; and, as they point out in the recent article in The Psychologist ('The journal of a mental hospital user in the 1960s', May 2012), their book is of 'considerable historical importance'. It is rarer to read accounts of life in the asylum from an 'inmate' perspective than from the professionals who worked there (Prior, 1993).

Some years ago I was privileged to work with a man who remembered in lucid detail his experiences as an inpatient at Cane Hill Hospital in Coulsdon, Surrey. We co-authored a paper on his reflections (Stevenson and Carson, 1995). While most of the old asylums have long since closed, Hallam and Bender are right to wonder whether 'the Davids' of today get better care in the community. For people with psychosis the development of CBT-based approaches have rightly been heralded as a significant advance. However, it is rare for CBT for psychosis to last longer than a year, and it is often less than this. In contrast many sufferers experience long-term problems with symptoms. The developing recovery approach requires a longer-term commitment from professionals. I worked with one man for over four years, before I retired from the service. I called him up yesterday to tell him our new book had just come out (McManus and Carson, 2012). He told me that his voices had kept him up for most of the previous night.

Yet this is a man who has not only had a full course of CBT from a centre of excellence, as well as a course of acceptance and commitment therapy from one of its leading exponents, not to mention fortnightly sessions with me. Maybe we do need to turn to the voluntary sector and organisations like the Hearing Voices Network as Hallam and Bender suggest, to provide sufferers with additional support.

Dr Jerome Carson
London E17

References.
McManus, G. & Carson, J. (2012). From communism to schizophrenia and beyond: One man's long march to recovery. London: Whiting and Birch.
Prior, E. (1993). Claybury: A century of caring. London: Forest Healthcare Trust.
Stevenson, V. & Carson, J. (1995). The pastoral myth of the mental hospital: A personal account. International Journal of Social Psychiatry, 41(2), 147–151.

 

Hazel Stevenson's column and an obituary for Professor David John Johnson (1957–2012) can be found on PDF version.